Retinal vessels before and after carotid endarterectomy

Purpose To elucidate short term changes in retinal circulation following carotid endarterectomy (CEA). Design Prospective, non‐randomized, cohort study. Subjects and controls Nine patients were examined before and 5 weeks after CEA. Control group of nine medically healthy subjects was examined at baseline. Methods Analysis of clinical ocular findings and aspects of retinal and choroidal circulation included best‐corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment biomicroscopy, fundus photography and dynamic vessel analyzer (DVA) measurements. Central retinal arterial equivalent (CRAE), central retinal vein equivalent (CRVE) and arteriovenous ratio (AVR) were determined from 30° disc centered photographs using semi‐automated software, Vesselmap. Main outcome measures Retinal circulation as expressed in CRAE, CRVE, AVR and DVA measurements. Results Preoperative ipsilateral CRVE was higher when compared to controls and to contralateral eyes: 235.8 μm (199.2–284.7) versus 205.9 μm (149.2–245.9) and versus 222.4 μm (200.7–259.4), p = 0.014 and p = 0.028, respectively. DVA flicker light‐induced venular vasodilatation increased postoperatively in ipsilateral eyes; 2.3% (0.3‐4.1) versus 2.6% (0.7‐5.1); p = 0.028. SFCT and IOP in ipsilateral eyes were comparable to contralateral eyes and controls preoperatively, and remained unchanged postoperatively. Conclusions After CEA, retinal venules in ipsilateral eye appear less dilated indicating normalization in retinal circulation. Furthermore, flicker light‐induced vasodilatation increase, suggesting improved retinal endothelial function postoperatively.